Date: 4 Nov 2017
Source: Muscat Daily [edited]
<http://www.muscatdaily.com/Archive/Oman/Ministry-confirms-MERS-CoV-case-54qv>

The Ministry of Health (MoH) has confirmed the diagnosis of a new case with the Middle East respiratory syndrome coronavirus (MERS-CoV). The patient is in his 20s and currently in a stable condition at one of the referral hospitals. In a statement, the ministry has stressed the readiness of all referral hospitals to deal with such cases through the effective applicable epidemiological surveillance system.
=========================
[This case is now the 2nd case of laboratory confirmed MERS-CoV infection reported by Oman in 2017. The previous case this year (2017) was reported to WHO on 30 Aug 2017, and reported by WHO on 12 Oct 2017 (see MERS-CoV (59): Oman, Saudi Arabia, WHO http://promedmail.org/post/20170913.5313874).

With the addition of this case, it is now the 10th laboratory confirmed case from Oman, in addition to 2 cases from Oman that were confirmed and reported by Thailand. More detailed information on this newly confirmed case would be greatly appreciated, including age, date of onset, date of laboratory confirmation, high risk exposure history and travel history in the 14 days preceding onset of illness and results of contact tracing/studies.

The HealthMap/ProMED map of Oman can be found at:
<http://healthmap.org/promed/p/124>. - ProMED Mod.MPP]
Date: Mon 8 May 2017
Source: Muscat Daily [edited]
<http://www.muscatdaily.com/Archive/Oman/44-cases-of-measles-registered-till-April-end-Ministry-of-Health-50m4#ixzz4gbFHsjxz>

The Ministry of Health on [Mon 8 May 2017] said that there has been an outbreak of measles in the country and announced the start of a National Measles Immunisation Campaign from 14 May [2017].

The ministry has issued a warning to citizens and residents about the outbreak of the potentially fatal disease.

HE Dr Ahmed bin Mohammed bin Obaid al Saeedi, Minister of Health, said, "The ministry has detected an outbreak of measles in the sultanate. In 2016, the number of confirmed cases touched 114. From January till the end of April 2017, 44 cases have been registered."

HE Dr Saeedi said that the factors that have contributed to the outbreak include an increase in the number of expats from neighbouring countries and the frequent movement of people from countries which have experienced outbreaks of communicable diseases including measles.

On the ministry's strategy, HE Dr Saeedi said that the sultanate is now considered to be in the elimination phase of measles and rubella.

He said that many strategies and activities have been adopted including surveillance, outbreak investigation, and preventive measures throughout these years to control the disease. "During the last few years, Oman reported a low incidence rate for measles which has reached almost zero local case per million population as per the World health Organization (WHO) indicators."

HE Dr Saeedi said that people between 20 and 35 years are more susceptible to the infection and play a role in transmitting it to the younger lot. The outbreak in Oman coincides with an increase in measles cases in a number of neighbouring countries, the Americas and Europe.

Speaking to Muscat Daily, a senior official from MoH said, "The ministry will implement the campaign for citizens and residents in the age group of 20-35 years. They will be administered MMR vaccine for protection against measles, mumps, and rubella. This is the same vaccine used to immunise children."

The ministry will run the campaign in 2 phases. In the 1st phase, the campaign will run from 14-20 May [2017] in Dhofar and Al Wusta. The 2nd phase will cover the rest of the country.

The vaccination is free for all citizens and residents (born between 1982 and 1997) and will be available at government healthcare institutions and centres. The dates for the 2nd phase of vaccination will be announced later.
====================
[Maps of Oman can be seen at <http://meteorites.wustl.edu/oman.jpg>
and <http://healthmap.org/promed/p/124>. - ProMED Mod.LK]
Date: Mon 20 Mar 2017, 3:35 PM
Source: Gulf News [edited]
<http://gulfnews.com/news/gulf/oman/congo-fever-kills-three-in-oman-1.1997098>

A total of 3 people have died and 6 other treated for Crimean-Congo Haemorrhagic Fever (CCHF) in Oman since the beginning of 2017, the Ministry of Health said. The fever claimed 7 lives in the country last year [2016], according to the Ministry of Health. In 2016, a number of livestock farms were shut down in the North and South Sharqiyah governorates of Oman, to limit the spread of CCHF.

Oman's Ministry of Agriculture and Fisheries has taken measures to limit the spread of the virus in farms. According to ministry's new measures only Omani nationals can import livestock for slaughtering purposes. Importing livestock for breeding purposes has been prohibited. Authorities told Gulf News they are monitoring and educating people on how to prevent the spread of the virus. Farmers have been advised to wear gloves and protective clothing while handling livestock.

People are also advised to avoid contact with blood or bodily fluids of livestock or humans who show symptoms of the virus. The 1st case of CCHF was reported in Oman in 1996. Those diagnosed with the virus have a 37.5 percent chance of dying and currently there is no vaccine available for the virus.
=============================
[Crimean-Congo haemorrhagic fever (CCHF) is a severe viral human disease with fatality rates up to 30 percent. It is a tick-borne disease described in more than 30 countries in Europe, Asia and Africa [1]. The causative agent is the Crimean-Congo hemorrhagic fever virus (CCHFV) that is a member of the genus Nairovirus of the family Bunyaviridae. An additional mode of transmission is direct contact of broken skin or mucous membranes with blood or tissues of infected livestock or CCHF patients [2]. Because of the associated high fatality rate, CCHF is considered to be a major public health threat.

In addition, the absence of an FDA-approved vaccine, and the potential for human-to-human transmission and nosocomial outbreaks, it is also considered to be a significant public health issue. CCHF is noted to be endemic in the neighboring countries in the Arabian Peninsula for instance, in the United Arab Emirates (UAE), Saudi Arabia and Kuwait [3-4]. CCHF cases were 1st reported in Oman in 1995 [5].

The case numbers for 2017 to date mentioned in the above report underline the importance of early diagnosis of suspected patients for proper management and prevention of nosocomial infections.

References
1. Schmaljohn CS, Nichol ST. Bunyavirida Fields virology, 5th ed, Vol. 2. Philadelphia, PA: Lippincott, William and Wilkins, 2007; 1741-1789.
2. Hoogstraal H. The epidemiology of tick-borne Crimean-Congo hemorrhagic fever in Asia, Europe, and Africa. J Med Entomol. 1979;15(4):307-417.
3. el-Azazy OM and Scrimgeour EM. Crimean-Congo haemorrhagic fever virus infection in the western province of Saudi Arabia. Trans R Soc Trop Med Hyg. 1997;91(3):275-8.
4. Rodriguez LL, Maupin GO, Ksiazek TG, et al. Molecular investigation of a multisource outbreak of Crimean-Congo hemorrhagic fever in the United Arab Emirates. Am J Trop Med Hyg. 1997 Nov;57(5):512-8.
5. Schwarz TF, Nitschko H, Jäger G et al. Crimean-Congo haemorrhagic fever in Oman. Lancet. 1995;346(8984):1230. - ProMED Mod.UBA]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/124>.]
Date: Mon 8 Aug 2016
From: Dr Seif Al-Abri, <salabri@gmail.com>, Dr Idris al-Abaidani and Dr Ali Al-Moqbali [edited]
-----------------------------------------
Brucellosis is one of the major zoonotic infectious diseases in Oman; it was mainly restricted to the southern part of the country in the Governorate of Dhofar. The region receives rainfall during June to August (Kharif season). Animal herding including cattle, camels, sheep and goats is the main profession of the people living in the mountains of Dhofar. A serosurvey conducted in 1985-86 in the animals in Dhofar Governorate revealed a prevalence of brucellosis of 8 per cent in camels, 6.4 per cent in goats and sheep and 3.3 per cent in cattle. The northern Governorates in Oman have shown a consistently low incidence for brucellosis in the past decades.

However, recently there has been a rise in the number of cases. A cluster of 55 brucellosis cases was identified during the period May to July 2016 from the coastal area in the north of Oman mainly in the North Batinah Governorate. The index case was confirmed by positive serology for _Brucella melitensis_ and a positive blood culture on 15 May 2016. Epidemiological investigation revealed 6 additional cases in the family. There was no history of visiting or staying in southern endemic area of Dhofar. There was a history of consumption of locally produced goat cheese. The local cheese producer had over 100 goats and a cow in his farm; it was his traditional family business.

Additional cases and family clusters were diagnosed during the period of intensive surveillance (15 May -- 31 Jul 2016). Several had a past history of consuming the locally produced goat cheese. The Ministry of Agriculture conducted a serosurvey among the farm animals of the cheese producer and the 23 seropositive goats were culled. Further investigations are ongoing and long term actions will be decided on the information in collaboration with the Ministry of Agriculture and the Municipality. A joint plan of action has been drafted to deal with the surge of the disease in the northern governorates of Oman with the aim of eradicating the diseases from animals in this part of the country.

As of 31 Jul 2016, 236 cases of brucellosis were reported to the Surveillance department at MoH, of which 71 (30 per cent) were from northern governorates. This proportion is over 3 times of the average of 2010 to 2015 (8.1 per cent). --
Dr Seif Al-Abri Dr Idris al-Abaidani Dr Ali Al-Moqbali Salem al-Mahrooqi Ministry of Health Muscat Sultanate of Oman
salabri@gmail.com
==================
[ProMED-mail thanks the authors for submitting this report. Brucellosis is zoonotic infection that can be spread not only by direct contact with the animal carrier but also by the ingestion of unpasteurized dairy products such as milk and cheese. The infection is also known as undulant fever, related to the occurrence of 1-3 week febrile periods separated by 1-3 days of afebrility. This occurs more likely with _Brucella melitensis_ (acquired from goats) than with _B. abortus_ (cattle) and _B. suis_ (swine). The infection can be subclinical. Acute symptomatic brucellosis is generally manifest with nonspecific symptoms such as fever, chills, night sweats, anorexia, and an increased sense of ill health.

The disease can be diagnosed serologically and/or by blood culture. The organism may grow quite slowly on primary isolation, and the clinician should make the microbiology laboratory aware of this potential diagnosis. Localized infection may occur. Sites for localization include the skeletal system (1), heart valves (2) and urinary tract (3). Genitourinary [GU] brucellosis may present identically to GU tuberculosis. Psychiatric manifestations such as depression and anxiety are possible as late symptoms of brucellosis (4, 5), so-called chronic neurobrucellosis. It remains unclear whether active brucella infection is present at that time. Overt central nervous system infection can, however, include meningitis and encephalitis (6,7).

References
--------------------
1. Beeching NJ, Madkour MM. Brucellosis. Chapter 28 in: Farrar J, Hotez P, Junghanss T, Kang G, Lalloo D, White NJ [eds.]. Manson's tropical diseases 23rd edition. London: Elsevier,  2013; 371-378.
2. Beeching NJ, Corbel MJ. Brucellosis: Chapter 194e in Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al [eds.]. Harrison's principles of internal medicine, 19th edition. McGraw-Hill, 2015; 194e1-5.
3. Leder K, Torresi J, Libman MD, et al. GeoSentinel Surveillance Network. GeoSentinel surveillance of illness in returned travellers, 2007-2011. Ann Intern Med. 2013; 158(6): 456-68; available at <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629801/>.
4. Pappas G, Papadimitriou P, Akritidis N, et al/ The new global map of human brucellosis. Lancet Infect Dis. 2006; 6(2): 91-9; abstract available at <http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(06)70382-6/abstract>.
5. Pappas G/ The changing _Brucella_ ecology: novel reservoirs, new threats. Int J Antimicrob Agents. 2010; 36 Suppl 1: S8-11; available at <http://www.ijaaonline.com/article/S0924-8579(10)00254-2/pdf>.
6. Dean AS, Crump L, Greter H, et al. Global burden of human brucellosis: a systematic review of disease frequency. PLoS Negl Trop Dis. 2012; 6(10): e1865; available at <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493380/>.
7. Garin-Bastuji B, Jaÿ M, Mick V. Review and update on brucellosis in Asia and Pacific Region. Presentation at the 4th FAO-APHCA/OIE/DLD Regional Workshop on Brucellosis Diagnosis and Control in Asia and Pacific Region -- Proficiency Test and Ways Forward for the Region. Chiang Mai, Thailand, 19‐21 March, 2014; available at ,<http://www.rr-asia.oie.int/fileadmin/Regional_Representation/Programme/Emerg/2014_Brucellosis_Chiang_Mai/Dr_Bruno_Garin-Bastuji.pdf>.
8. Wongphruksasoong V, Santayakorn S, Sitthi W, et al/ An outbreak of Brucella melitensis among goat farmers in Thailand, December 2009. OSIR. 2012; 5(1): 14-21; available at <http://www.osirjournal.net/issue.php?id=30>.
9. Ekpanyaskul C, Santiwattanakul S, Tantisiriwat W, Buppanharun W. Factors associated with seropositive antibodies to Brucella melitensis in the Nakhon Nayok, Thailand. J Med Assoc Thai. 2012; 95 Suppl 12: S40-6; available at <http://www.pubfacts.com/detail/23513464/Factors-associated-with-seropositive-antibodies-to-Brucella-melitensis-in-the-Nakhon-Nayok-Thailand>. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/124>.]
Date: Sun 5 Jun 2016
Source: Gulf News [edited]
<http://gulfnews.com/news/gulf/oman/omani-dies-after-contracting-congo-fever-from-livestock-1.1840841>

An Omani man died of haemorrhagic Congo fever at Sultan Qaboos hospital in Salalah province, [Dhofar governorate] in the southern part of Oman on [Fri 3 Jun 2016], according to the Ministry of Health. The ministry said the man had contracted the disease from handling livestock.

Crimean-Congo haemorrhagic fever has claimed 8 lives in 2016 so far, according to the Ministry of Health. In 2015, Omani authorities reported 20 cases, and 20 per cent of the patients died. The 1st case in Oman was reported in 1995.  [byline: Fahad Al Mukrashi]
===================
[The 1st case of Crimean-Congo hemorrhagic fever (CCHF) in Oman was reported in 1995.

Between January and April 2016, Oman recorded 6 confirmed CCHF cases, 3 of which were fatal
(<http://timesofoman.com/article/82756/Oman/Health/Oman's-Ministry-of-Health-announces-two-Crimean-Congo-deaths>).
The number of fatal cases has increased since then to 8, including the one reported here.

In 2015, health authorities treated 20 patients who contracted tickborne viral diseases, endemic in Africa, the Balkans, the Middle East, and Asia in particular.

The patient in this report had exposure to livestock, which may well have been the exposure leading to disease transmission.

The following prevention and control options are currently available for CCHF:
- education to the high risk groups for possible exposure practices;
- vector/tick control: acariciding (to kill or to destroy mites with a special solution) is not a practical measure except in well managed livestock facilities;
- use of personal protection: prevention of tick bites, avoidance, use of repellents, use of gloves, protective clothing by animal handlers. - ProMED Mod.UBA]

[Maps of Oman can be seen at
<http://www.mapsofworld.com/oman/maps/oman-political-map.jpg> and
<http://healthmap.org/promed/p/6565>. - ProMED Sr.Tech.Ed.MJ]
More ...